Hemotympanum as a Complication of a Valsalva Maneuver during Childbirth

Background. Hemotympanum may occur due to otic barotrauma secondary to Valsalva maneuver during the second phase of labor. A pressure differential across the tympanic membrane (TM) of about five psi can cause rupture. The increased intrathoracic and intraabdominal pressure spikes repeatedly manifest...

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Main Authors: Tali Teitelbaum, Isaac Shochat, Golda Grinblat, Mohamad Taha, Itzhak Braverman
Format: Article
Language:English
Published: Wiley 2023-01-01
Series:Case Reports in Otolaryngology
Online Access:http://dx.doi.org/10.1155/2023/3328895
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author Tali Teitelbaum
Isaac Shochat
Golda Grinblat
Mohamad Taha
Itzhak Braverman
author_facet Tali Teitelbaum
Isaac Shochat
Golda Grinblat
Mohamad Taha
Itzhak Braverman
author_sort Tali Teitelbaum
collection DOAJ
description Background. Hemotympanum may occur due to otic barotrauma secondary to Valsalva maneuver during the second phase of labor. A pressure differential across the tympanic membrane (TM) of about five psi can cause rupture. The increased intrathoracic and intraabdominal pressure spikes repeatedly manifested by “pushing” during second-stage labor easily approach (and may exceed) this level. Clinical Presentation. This case report describes a healthy thirty-seven-year-old multipara patient admitted for the 40-weeks’ gestational age routine follow-up that proceeded to active labor followed by an aural fullness and bloody otorrhea. Otoscopic examination with a light microscope confirmed the hemotympanum of the right tympanic membrane. Conclusion. Forceful Valsalva can cause hemotympanum. Investigating the benefits and disadvantages of the pushing methods could help reduce such complications in the future. A prompt evaluation of an otolaryngologist should be requested in the event of a new postpartum hearing disturbance or bloody otorrhea.
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spelling doaj-art-7074ff6071f4459aae3c48b45aaee4322025-08-20T03:19:12ZengWileyCase Reports in Otolaryngology2090-67732023-01-01202310.1155/2023/3328895Hemotympanum as a Complication of a Valsalva Maneuver during ChildbirthTali Teitelbaum0Isaac Shochat1Golda Grinblat2Mohamad Taha3Itzhak Braverman4Hillel Yaffe Medical CentreHillel Yaffe Medical CentreHillel Yaffe Medical CentreHillel Yaffe Medical CentreHillel Yaffe Medical CentreBackground. Hemotympanum may occur due to otic barotrauma secondary to Valsalva maneuver during the second phase of labor. A pressure differential across the tympanic membrane (TM) of about five psi can cause rupture. The increased intrathoracic and intraabdominal pressure spikes repeatedly manifested by “pushing” during second-stage labor easily approach (and may exceed) this level. Clinical Presentation. This case report describes a healthy thirty-seven-year-old multipara patient admitted for the 40-weeks’ gestational age routine follow-up that proceeded to active labor followed by an aural fullness and bloody otorrhea. Otoscopic examination with a light microscope confirmed the hemotympanum of the right tympanic membrane. Conclusion. Forceful Valsalva can cause hemotympanum. Investigating the benefits and disadvantages of the pushing methods could help reduce such complications in the future. A prompt evaluation of an otolaryngologist should be requested in the event of a new postpartum hearing disturbance or bloody otorrhea.http://dx.doi.org/10.1155/2023/3328895
spellingShingle Tali Teitelbaum
Isaac Shochat
Golda Grinblat
Mohamad Taha
Itzhak Braverman
Hemotympanum as a Complication of a Valsalva Maneuver during Childbirth
Case Reports in Otolaryngology
title Hemotympanum as a Complication of a Valsalva Maneuver during Childbirth
title_full Hemotympanum as a Complication of a Valsalva Maneuver during Childbirth
title_fullStr Hemotympanum as a Complication of a Valsalva Maneuver during Childbirth
title_full_unstemmed Hemotympanum as a Complication of a Valsalva Maneuver during Childbirth
title_short Hemotympanum as a Complication of a Valsalva Maneuver during Childbirth
title_sort hemotympanum as a complication of a valsalva maneuver during childbirth
url http://dx.doi.org/10.1155/2023/3328895
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